The Rising Humanitarian Tide

by John Pringle

(version français à la suite)

“Every ship is unsinkable, until it sinks” (Crawley, 2010). So it is with human rights: inviolable until they are denied. The right to protection from war, the right to maritime rescue, the right to seek asylum, the right to life’s necessities, the right to health care, and the right to be treated humanely and with dignity: the words are failing the very people they were written to protect. Who would have thought, that in the 21st century, we would have to argue defensively for pulling drowning people from the sea. The humanity principle – that people are entitled to assistance and to be treated humanely simply by virtue of being human – is not and never has been a given. Lives are not valued equally, some not at all.

That human lives are undervalued may come as a shock. Unless you are an aid worker. As an aid worker, you may have seen a child die for lack of a ten cent measles vaccine – measles kills about 400 children every day (WHO, 2015). You may have seen a patient suffer for lack of an available treatment – diseases of poverty are invisible to pharmaceutical companies (Access Campaign, 2015). As an aid worker, you will have witnessed how the global economic system values people for their wealth. And it values profit. Apart from that, it sees nothing of value (Patel, 2010).

The Global Refugee Crisis is a stark reminder that we live in a world of disparity. The old mantra, “a rising tide lifts all boats”, argues that what is good for the economy is good for everybody. But in the context of a Mediterranean graveyard, the rising tide cliché is not just ironic but grotesque. After decades of neoliberal economic policies, the tide has lifted only luxury yachts and military patrol vessels.

I was fortunate to attend the MSF OCA Café in Amsterdam (September 12, 2015) on behalf of MSF Canada. At the session, attendees struggled to make sense of the Global Refugee Crisis – the largest displacement of people since the Second World War – that is washing up on the shores of Europe. MSF has been deeply involved, from participating in maritime search and rescue operations to providing health care in reception centres. The challenge for MSF is in formulating a narrative for advocacy. We can implore governments to fulfill their legal commitments to asylum seekers and to accept refugees, but we should not overlook the ideological roots of political indifference. People are not drowning in the sea because the system is broken, but because the system is functioning according to its logic: providing safe harbour for capital, while washing away the dispossessed. And it relegates refugees, asylum-seekers, and migrants – the collateral damage of empire and globalization – to the domain of private charities like MSF.

It is a “dangerous delusion” to think of the global economy a natural system. It is the product of ideology-driven macro-economic policies (Labonté & Schrecker, 2007). Over the last four decades, the dominant ideology has been neoliberalism. Neoliberalism holds that the secret to a growing economy is laissez-faire capitalism. It calls for the privatization of public goods such as land, water, education, and healthcare. It calls for the deregulation of finance and the elimination of environmental and labour standards. It calls for reduced taxes, fiscal austerity, and the gutting of government services. It privileges the private sector and abhors the welfare state.

Neoliberalism stems from the economic theories of Milton Friedman. It was championed by US President Ronald Reagan, UK Prime Minister Margaret Thatcher, and Chilean dictator Augusto Pinochet. Globally, its policies are ubiquitous and enshrined in the World Bank, the International Monetary Fund and the World Trade Organization. It is furthered by multilateral trade agreements such as the Trans-Pacific Partnership. And it is enforced by (often CIA-supported) repression against popular movements and organized labour (Harvey, 2005; Klein, 2007). It is so ingrained in our psyche that it has been called the “end of history”. Many find it easier to imagine the end of the world than the end of capitalism (Fisher, 2009).

But its medicine is bitter and frequently toxic. Deregulation of the financial sector caused the Global Financial Crisis of 2008, the worst financial crisis since the Great Depression. As people lost their jobs, their savings and their social programs, banks and corporations received huge government bailouts, demonstrating that welfare is acceptable for corporations but not for struggling families (Farnsworth, 2012; Rolling Stone, 2013). In the Global Financial Crisis, neoliberal capitalism’s true essence was revealed: private gains and public losses. The ripples of the crisis still span across the world, but we saw counter-forces in the Occupy Movement, the Arab Spring, and other anti-austerity democratic movements.

Neoliberal capitalism is like a machine that concentrates wealth. 92 billionaires own the same amount of wealth as 3.5 billion people, the poorer half the entire human population (Oxfam, 2015). This extreme power imbalance has never before been seen in human history. To sustain it requires a militarized surveillance state, an army of private security, and entrenched national borders that are shut to people in flight.

If neoliberal capitalism were an experiment, it would have been deemed a failure. So why do we hang on to it? As the author Upton Sinclair wrote, “It is difficult to get a man to understand something, when his salary depends upon him not understanding it.”

Global wealth is increasingly being concentrated in the hands of a small wealthy elite. These wealthy individuals have generated and sustained their vast riches through their interests and activities in a few important economic sectors, including finance and pharmaceuticals and healthcare. Companies from these sectors spend millions of dollars every year on lobbying to create a policy environment that protects and enhances their interests further (Oxfam, 2015).

Those fleeing war, persecution and poverty fall outside the corporate agenda because their needs are beyond their ability pay. Instead, the precariat – an amalgam of precarious and proletariat (Standing, 2011) – must depend on private charities. Philanthro-capitalism sees wealthy donors looking after aid organizations, which in turn look after the precariat, not because the humanity principle has currency, but because aid organizations perform a necessary function. Financed through donations rather than taxation, aid organizations provide the necessary amount of assistance to suppress disease outbreaks and rebellion.

Through its commitment to assisting people in flight, MSF is able to convey clarity and perspective to the crisis. We can serve our beneficiaries by countering xenophobic and fascist ideologies that blame the poor for their poverty and refugees for their fate. We can provide an alternate and coherent narrative of the root causes of forced displacement, and impart these two truths: no one is illegal and fences kill. We can provide empirical evidence about the effects of imperialistic and predatory economic policies on the communities we serve. We can preserve our neutrality through objectivity in the spirit and language of the social determinants of health. We are using this approach successfully in the Access Campaign and in opposing harms from Trans-Pacific Partnership trade agreement (MSF, 2015). Our defiant humanitarianism will counter the medicalization of social injustices, which is a growing and disturbing trend in the NGO-ization of global health governance.

The MSF Nobel Prize acceptance speech declared that “humanitarianism occurs where the political has failed or is in crisis”. This does not tell the whole story. Increasingly, humanitarianism is occurring where the political has not failed but is unfolding according to its logic: allocating the precariat to a technocratic humanitarian sector while distracting with grand promises (today it is the Sustainable Development Goals). The rising humanitarian tide may be keeping many afloat. But just as “every ship is unsinkable until it sinks”, every tide rises until it falls.

John Pringle (@johndpringle_) is a nurse and epidemiologist with a PhD in public health and bioethics from the University of Toronto. He is currently a Postdoctoral Fellow in humanitarian health ethics at McGill University. His work takes a critical approach to bioethical issues surrounding humanitarian action under globalization and global health governance. In addition to his work in Canada, he is a member of Médecins Sans Frontières (MSF) and has worked in Eritrea, northern Nigeria, and most recently in Sierra Leone during the Ebola crisis.

Previously published in Petites Nouvelles Newsletter (PNN) of the MSF Canada Association, October 2015.

Crawley, R. (2010). Character from “Downton Abbey” Episode 1.1. “Every mountain is ‘unclimbable’ until someone climbs it. So every ship is ‘unsinkable’ until it sinks”. UK: Carnival Films and Masterpiece.

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2 comments

Well said! The greed and reach of big business is absolutely out of control! Those farther up in this hierarchy have always been resistant to any notion of humanitarian ideals…we will have to fight for it!!
I don’t recall who’s quote this is but I’ve always felt it to be accurate.
” if no one had too much…everyone would have enough”.

Well said! The greed and reach of big business is absolutely out of control. Those farther up in this hierarchy are very resistant to the notion of humanitarian ideals….we will have to fight for it!
I don’t recall the author but I’ve always found this quote to resonate.
” if no one had too much…everyone would have enough”.

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The hhe research group seeks to publish innovative and thought-provoking reflections on issues related to humanitarian health ethics. The views and opinions expressed in the publications do not necessarily reflect those of all hhe research group or HumEthNet members.